Childhood Leukemia Cancer
Leukemia is a blood-based cancer that begins in the bone marrow, the soft inner part of the bone responsible for the growth of new blood cells. As leukemia cells accumulate in the bone marrow, by replicating more quickly than normal cells and not dying when they should, they begin to crowd out healthy cells and then quickly spread into the blood stream. Once in the blood stream, the leukemia cells move to different areas of the body and begin to impact the ability of other organs to function normally. Leukemia is the most common type of cancer in children, accounting for nearly one-third of all childhood cancers, and should not be confused with other types of cancers that begin in other organs and then spread to the bone marrow.
In children, there are two main types of leukemia, both of which are acute (quickly growing):
- Acute lymphocytic (lymphoblastic) leukemia (ALL): ALL develops in immature lymphocytes, the white blood cells responsible for helping the body fight infections and bacteria. In general, ALL is the most common type of childhood leukemia: about three out of four cases. Most cases of ALL start in so-called B cells, the lymphocytes responsible for making antibodies for fighting viruses; however, some cases of ALL can begin in the T cells, which help fight infection themselves.
- Acute myelogenous leukemia (AML): Approximately one out of four cases of childhood leukemia are designated as AML, also known as acute myeloid leukemia, acute myelocytic leukemia, or acute non-lymphocytic leukemia. AML begins in the myeloid cells responsible for creating non-lymphocytic white blood cells, red blood cells, and platelets.
Juvenile myelomonocytic leukemia (JMML) is a very rare type of childhood leukemia that usually occurs in children under the age of 4. Like AML, it begins in the myeloid cells, but it does not grow as quickly as traditional AML (yet grows more quickly than chronic leukemia common in adults). Chronic (slow-growing) leukemias such as chronic myelogenous leukemia (CML) and chronic lymphocytic leukemia (CLL) are extremely rare in children.
Childhood Leukemia: Detection and Diagnosis
The most common symptoms of childhood leukemia, such as fatigue, headaches, paleness, fever and infection, and easy bruising and bleeding are very similar to the symptoms of many routine childhood illnesses. However, should these symptoms persist, reoccur frequently, and/or gradually worsen over time, your pediatrician may recommend that your child undergo testing with a pediatric oncologist to detect the potential presence of leukemia.
The first step in detecting and diagnosing childhood leukemia is a simple blood test. A complete blood count (CBC) will determine how many cells of each type (red blood cells, white blood cells, and platelets) are present in the blood; high numbers of white blood cells and low numbers of red blood cells and platelets may indicate the presence of leukemia. The blood sample will also be examined under a microscope to look for abnormalities in the blood cells themselves.
A blood test can indicate the potential presence of leukemia, but is not sufficient for diagnosis. In order to diagnose leukemia, bone marrow aspiration and biopsy are required. These two procedures are usually performed at the same time. During an aspiration, a thin, hollow needle is inserted in to the bone while a small amount of bone marrow is removed through a syringe. Then, a small piece of bone and marrow is removed with a slighter larger needle in order to perform a bone marrow biopsy.
Once leukemia has been diagnosed through a bone marrow aspiration and biopsy, the pediatric oncologist may require several additional tests in order to look for leukemia cells in other parts of the body. These tests can help classify and stage the leukemia, as well as determine the appropriate course of treatment. Additional tests may include:
- Lumbar puncture (spinal tap): to detect leukemia cells in the cerebrospinal fluid
- Chest x-ray: to detect enlarged thymus or lymph nodes, as well as pneumonia and lung infection
- CT scan or MRI: to detect the presence of leukemia in lymph nodes, spleen, liver, brain, and/or spinal cord
- PET scan: helpful for determining the extent to which leukemia cells have spread throughout the body
If these tests reveal the presence of childhood leukemia, your child’s oncologist will work with you to develop an appropriate course of treatment.
About American Childhood Cancer Organization
American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer. And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.
Illustration by By Mikael Häggström (All used images are in public domain.) [Public domain], via Wikimedia Commons